Provider Demographics
NPI:1114536091
Name:HAYS, SHANNON K (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:K
Last Name:HAYS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12651 IZZY MULE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-2741
Mailing Address - Country:US
Mailing Address - Phone:615-594-2800
Mailing Address - Fax:
Practice Address - Street 1:13143 EL CAMINO LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3512
Practice Address - Country:US
Practice Address - Phone:615-594-2800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2587103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist